Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Aug 2019
ReviewOpioids in cancer-related pain: current situation and outlook.
Despite progress in treatments, cancer pain remains underestimated, poorly assessed and under-treated. Prescribing strong opioids, because of their specificities, requires precision in management considering their pharmacology but also a clear understanding of recommendations. Some clinicians highlight the risk of addiction, excessive sedation and respiratory depression and their need for information. Our objective in this review is to suggest some clinical guidance for the positioning and daily use of opioids within cancer pain management. ⋯ Cancer pain is multimorphic and permanently changing due to disease evolution, curative treatments and disruptive events (concomitant treatments, pain from associated disease, comorbidities and complications, modifications of the environment). Well-managed opioids are the cornerstone of a complex environment requiring multidisciplinary dynamic assessments integrated into the patient's care pathway.
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Support Care Cancer · Aug 2019
Clinical TrialHigh concentration of topical amitriptyline for treating chemotherapy-induced neuropathies.
Chemotherapy-induced peripheral neuropathy (CIPN) is a devastating pain condition of cancer therapy that may force chemotherapy dose reduction or discontinuation. Since treatment options for CIPN are quite limited, we investigated the effect of 10% amitriptyline cream on neuropathic pain. ⋯ Considering the limited efficacy of conventional systemic treatments in CIPN and their safety profile, 10% topical amitriptyline appears to be a good candidate for first-line CIPN therapy, allowing continuation of chemotherapy at effective doses. The results are worth to be confirmed in a placebo-controlled clinical trial.
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Support Care Cancer · Aug 2019
A nationwide survey of adherence to analgesic drugs among cancer patients in Taiwan: prevalence, determinants, and impact on quality of life.
Poor adherence to analgesic drugs is one of the most common barriers to adequate pain management. This prospective, cross-sectional, patient-oriented observational study aimed to explore the adherence rate, clinical factors, and impact of adherence to analgesic drugs on the quality of life (QoL) among cancer outpatients in Taiwan. ⋯ Awareness of the clinical factors associated with adherence to analgesic drugs may help clinicians to identify cancer patients at a greater risk of non-adherence, reinforce optimal pain management, and improve the QoL by enhancing adherence to pain medications.
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Support Care Cancer · Aug 2019
Symptom hyper-expression in advanced cancer patients with anxiety and depression admitted to an acute supportive/palliative care unit.
The aim of this study was to compare symptom expression in advanced cancer patients with depression and anxiety and in patients with no such symptoms. ⋯ Psychological symptoms of ESAS concur to hyper-express some symptoms and make symptom control more difficult. A clear association between anxiety and depression exists.
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Support Care Cancer · Aug 2019
Integrative medicine therapeutic approaches to cancer care: patient preferences from focus groups.
To understand patient preferences for integrative therapeutics and/or modalities during cancer care. ⋯ Qualitative research may facilitate understanding the scope of cancer patient preferences regarding the desire and use of integrative therapeutic modalities. A conceptual understanding of cancer patient preferences regarding integrative therapies and modalities may best inform successful direction and efficacy of treatment strategies.